Cemal TAŞDEMİR, Ramazan ALTINTAŞ, Ali GÜNEŞ, Fatih OĞUZ, Serhan ÇİMEN, Ali BEYTUR

The efficacy and reliability of extracorporeal shockwave lithotripsy(eswl) nin pediatric urolithiasis: Our clinical experiences

Amaç: Beden dışı şok dalgaları ile taş kırma (ESWL) tedavisi, erişkin hastalarda olduğu gibi çocuk yaş grubunda da son yıllarda sıkçauygulanan bir tedavi yöntemidir. Bu çalışmada kliniğimizde böbrek ve üreter taşları nedeniyle ESWL uygulanan çocuklarda tedavi sonuçlarınıve komplikasyonları retrospektif olarak değerlendirdik. Gereç ve Yöntemler: Bu çalışmada Ocak 1998 ve Şubat 2013 arasında böbrek ve üreter taşlarının tedavisi için Stonelith PCK V-5Lithotriptor cihazı kullanılarak ESWL uygulanan 282 pediatrik hastanın verileri değerlendirmeye alındı. ESWL işlemi supin pozisyonunda ve20-45 dakikalık seanslar şeklinde yapıdı. Her ESWL seansında en az 2000 en fazla 3500 şok dalgası, 13 kVdan başlayıp gereken hastalardaen fazla 17 kV olacak şekilde artırılarak uygulandı. Bulgular: Yüzbeş kız ve 177 erkek hastanın ortalama yaşı 10,41 (1-17) yıl idi. Ortalama taş yükü 1,3 cm 2 (0,5-5 cm2) (böbrek taşları için 1,58cm 2, üreter taşları için 1,02 cm2) olup toplam 392 seans ESWL uygulandı. İki yüz dört hastada fentanil ve/veya ketamin ile sedoanaljezigerekti. Tam taşsızlık oranı % 82,2 olarak bulundu. Seksen yedi hastada hematüri, 62 hastada da deri ekimozları minor komplikasyon olarakgörüldü. Kalan taşların tedavisi için ek girişim olarak 14 hastaya üreterorenoskopi ve 19 hastaya da perkütan nefrolitotomi uygulandı.Sonuç: ESWL çocuk yaş grubundaki üriner sistem taş hastalığı tedavisinde düşük morbidite, minimal anestezi ile ayaktan günübirlikuygulanabilirliği ve yüksek taşsızlık oranı ile sıkça kullanılan bir tedavi yöntemidir.

Çocukluk çağı üriner sistem taş hastalığında extracorporeal shockwave lithotripsy (eswl) nin etkinliği ve güvenilirliği: Klinik deneyimlerimiz

Objectives: As in adult patients, Extracorporeal Shockwave Lithotripsy treatment is a frequently used treatment in pediatrics. In thisstudy, we retrospectively evaluated the results and the complications of ESWL treatment in children for renal and ureteral stones.Material and Methods: In this study, we included the data of 282 pediatric patients that underwent ESWL using Stonelith PCK V-5Lithotriptor device for the treatment of renal and ureteral stones between January 1998 and February 2013. ESWL procedure is conductedn the supine position and with sessions of 20-45 mins. Each ESWL session exercised at least 2000 up to 3500 shock waves with 13 kVncreasing up to 17 kV according to the severity of the case. Results: The mean age of 105 girls and 177 boys was 10.41 (range: 1-17). The mean stone burden was 1.3 cm 2 (range: 0.5-5 cm 2) (1.58 cm2 for kidney stones and 1.02 cm 2 for ureteral stones) and a total of 392 ESWL sessions were performed. Fentanyl and/or ketamine sedo- analgesia were required in 204 patients. The complete stone free rate was 82.2 %. Hematuria, in 87 patients, and skin brushing, in 62, werethe only minor complications. Ureterorenoskopy in 14 patients and percutaneous nephrolithotomy in 19 patients were performed asadditional intervention for the treatment of the residual stones. Conclusion: ESWL is a commonly used treatment method with low morbidity, applicability with minimal need for anesthesia, and highstone-free rate in the treatment of pediatric urolithiasis.

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